Guided by the Knowledge-Attitude-Practice (KAP) model, a multi-disciplinary team conducted this study from March to August 2024. A mixed-methods approach was adopted. First, a preliminary item pool was developed through a literature review and semi-structured interviews. The items were subsequently screened and refined via a two-round Delphi expert consultation. Finally, the Analytic Hierarchy Process (AHP) was used to determine the weight of each indicator.

The effective response rates for the two Delphi rounds were 88.9% and 100%, with authoritative coefficients of 0.932 and 0.943, respectively. Kendall's W coefficients for all tiers of indicators ranged from 0.244 to 0.365 in the first round and 0.313 to 0.459 in the second round (all P < 0.01), demonstrating a high degree of expert consensus and authority. The final evaluation system comprises 3 first-level, 14 second-level, and 51 third-level indicators. These indicators are organized into three core dimensions: Health Knowledge (e.g., radiotherapy basics, medication, complication management), Health Attitude (e.g., perception, health motivation), and Health Practice (e.g., symptom management, nutritional management, treatment adherence), systematically capturing the patient's progression from knowledge acquisition to belief internalization and behavioral change.